title: The effect of treatment with ketoconazole on central CRH systems  of depressed patients.
abstract: OBJECTIVE
  Steroid-synthesis inhibitors are reported to reduce psychopathology in treatment-resistant depressed patients.
  
  
  METHODS
  We studied the effect of a 3-week treatment with ketoconazole on the evening plasma concentrations of cortisol, corticosteroid-binding globulin (CBG), dehydroepiandrosterone-sulfate (DHEA-S) and adrenocorticotrope hormone (ACTH) as well as morning cerebrospinal fluid (CSF) concentrations of cortisol, corticotropin-releasing hormone (CRH) and arginine-vasopressin (AVP) in six elderly treatment-resistant depressed patients.
  
  
  RESULTS
  While we found plasma cortisol concentrations to be unchanged, a decline in plasma DHEA-S concentrations indicated effective steroid-synthesis inhibition. In morning CSF we found CRH concentrations that did not change.
  
  
  CONCLUSIONS
  Our preliminary observations indicate that the treatment of depressed patients with the steroid-synthesis inhibitor ketoconazole does not lead to a major increase in CSF CRH secretion.
authors.affiliation: Central Institute of Mental Health, Mannheim, Germany. Georgios.Paslakis@zi-mannheim.de
authors.forename: Georgios
authors.initials: G
authors.lastname: Paslakis
authors.forename: Olivera
authors.initials: O
authors.lastname: Lecei
authors.forename: Günther K
authors.initials: GK
authors.lastname: Stalla
authors.forename: Rainer
authors.initials: R
authors.lastname: Landgraf
authors.forename: Manfred
authors.initials: M
authors.lastname: Uhr
authors.forename: Bettina
authors.initials: B
authors.lastname: Hamann
authors.forename: Peter
authors.initials: P
authors.lastname: Luppa
authors.forename: Maria
authors.initials: M
authors.lastname: Gilles
authors.forename: Isabella
authors.initials: I
authors.lastname: Heuser
authors.forename: Michael
authors.initials: M
authors.lastname: Deuschle
mesh_terms: D058888:14-alpha Demethylase Inhibitors / Q000494:pharmacology; D000368:Aged; D000369:Aged, 80 and over; D001127:Arginine Vasopressin / Q000134:cerebrospinal fluid; D003346:Corticotropin-Releasing Hormone / Q000134:cerebrospinal fluid*; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000503:physiopathology; D004351:Drug Resistance; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000134:cerebrospinal fluid; D007654:Ketoconazole / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D013997:Time Factors
chemical_list: D058888:14-alpha Demethylase Inhibitors; D001127:Arginine Vasopressin; D019314:Dehydroepiandrosterone Sulfate; D003346:Corticotropin-Releasing Hormone; D007654:Ketoconazole; D006854:Hydrocortisone